White infarct is seen in –
**Core Concept**
Lobar cerebral infarcts, also known as white infarcts, occur due to occlusion of a major cerebral artery, leading to ischemia and necrosis of the cortical gray matter. This type of infarct is characterized by a clear boundary between the infarcted area and the surrounding brain tissue.
**Why the Correct Answer is Right**
The correct answer is related to the pathophysiology of cerebral ischemia. When a major cerebral artery is occluded, the blood supply to the affected cortical area is severely compromised, leading to ischemia and eventually necrosis of the gray matter. This type of infarct is often seen in the distribution of the middle cerebral artery (MCA), which supplies the majority of the lateral surface of the brain. The MCA occlusion leads to a well-demarcated area of infarction, which is typically seen on imaging studies.
**Why Each Wrong Option is Incorrect**
**Option A:** This option is incorrect because white infarcts are not typically associated with small vessel disease or lacunar infarcts, which are usually seen in deeper brain structures such as the basal ganglia or thalamus.
**Option B:** This option is incorrect because white infarcts are not typically associated with brainstem or cerebellar infarcts, which are usually seen in the distribution of the posterior cerebral artery or vertebral arteries.
**Option C:** This option is incorrect because white infarcts are not typically associated with posterior circulation infarcts, which are usually seen in the distribution of the posterior cerebral artery or vertebral arteries.
**Clinical Pearl / High-Yield Fact**
Remember that white infarcts are often seen in the distribution of the middle cerebral artery (MCA) and are characterized by a clear boundary between the infarcted area and the surrounding brain tissue.
**Correct Answer: D. Lobar cerebral infarct**